Document Detail


Vitamin D and parathyroid hormone in outpatients with noncholestatic chronic liver disease.
MedLine Citation:
PMID:  17222588     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: The liver plays a central role in vitamin D metabolism. Our aim was to determine the prevalence and type of vitamin D-parathyroid hormone (PTH) disturbance in ambulatory patients with noncholestatic chronic liver disease (CLD) and its relationship with disease severity and liver function. METHODS: We studied 100 consecutive outpatients (63 men, 37 women; mean age, 49.0 +/- 12.1 [SD] y) with noncholestatic CLD caused by alcohol (n = 40), hepatitis C (n = 38), hepatitis B (n = 12), autoimmune hepatitis (n = 4), hemochromatosis (n = 4), and nonalcoholic steatohepatitis (n = 2); 51 patients had cirrhosis. Serum concentrations of 25-hydroxyvitamin D (25[OH]D), PTH, calcium, phosphate, magnesium, creatinine, and liver function tests were determined. RESULTS: Serum 25(OH)D levels were inadequate in 91 patients: vitamin D deficiency (<50 nmol/L) was found in 68 patients and vitamin D insufficiency (50-80 nmol/L) was found in 23 patients. Secondary hyperparathyroidism (serum PTH, >6.8 pmol/L) was present in 16 patients. The prevalence of vitamin D deficiency was significantly higher in cirrhotic vs noncirrhotic patients (86.3% vs 49.0%; P = .0001). In Child-Pugh class C patients, 25(OH)D levels were significantly lower than in class A patients (22.7 +/- 10.0 nmol/L vs 45.8 +/- 16.8 nmol/L; P < .001). Serum 25(OH)D independently correlated with international normalized ratio (negatively; P = .018) and serum albumin (positively; P = .007). Serum 25(OH)D levels of less than 25 nmol/L predicted coagulopathy, hyperbilirubinemia, hypoalbuminemia, increased alkaline phosphatase, and anemia and thrombocytopenia. CONCLUSIONS: Vitamin D inadequacy is common in noncholestatic CLD and correlates with disease severity, but secondary hyperparathyroidism is relatively infrequent. Management of CLD should include assessment of vitamin D status in all patients and replacement when necessary.
Authors:
Leon Fisher; Alexander Fisher
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2007-01-10
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  5     ISSN:  1542-7714     ISO Abbreviation:  Clin. Gastroenterol. Hepatol.     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-20     Completed Date:  2007-05-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  513-20     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, Canberra Hospital, ACT, Australia. leonfisher@optusnet.com.au
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Biological Markers / analysis
Cholestasis
Chronic Disease
Cohort Studies
Disease Progression
Female
Humans
Linear Models
Liver Diseases / blood,  pathology*,  physiopathology*
Liver Function Tests
Male
Middle Aged
Multivariate Analysis
Outpatients
Parathyroid Hormone / analysis,  metabolism*
Probability
Prognosis
Reference Values
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
Sex Factors
Vitamin D / analysis,  metabolism*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Parathyroid Hormone; 1406-16-2/Vitamin D

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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